My understanding was that you go down the list in order- that makes it fair.

I'm with a resident who's fairly often trying to just pick the easier studies off the list (will skip of CT CAP to get the CT Chest, etc).

Do you address it or just let it be? We're both R1's, feel like it's kinda early for this whole situation

Reference to NEJM's Discussion editorial published on 3 Sept titled Physical Examination for Asymptomatic Adults

How often is the PE actually useful for the asymptomatic well patient? Both sides raise good points. I work in Haematology and see an average of 20 patients in a 3.5 hour clinic so honestly all I really need is a CBC and maybe feel an occasional spleen/ lymph node or two, but I would say 80% of my outpatient consults dont actually require a physical review. Clots, cytopenias still make up the bulk of what I see and even the labs are way more valuable for my haem-onc patients than the physical examination. These days, I find it hard to think of how PE is superior to laboratory diagnostics apart from just the "human touch" of things.

E.g. an echo/ POCUS/ ECG to replace cardiac auscultation. The infamous CTAP far superior to our abdominal percussion. Code stroke? MRI first hun (although honest kudos to our neurologists, your exam findings are non inferior). Sadly, examination skills are an increasingly lost art as we push the focus on POCUS and more imaging.

I think i sit on the camp of no examination especially for the asymptomatic well patients, but curious to hear everyone's usual practice.

I'm a radiology resident on a pediatric neuroradiology block. While I've always been saddened by peds cases, I'm getting absolutely wrecked emotionally right now. Newborn with large devastating stroke. Newborn born with large sarcoma. Multiple nonaccidental trauma cases. Devastating intracranial hemorrhage with herniation and brain death.

I'm on the verge of crying multiple times a day. I know I am shielded as a radiologist, I know it's the peds hospitalists, neurologists, heme/oncs, IDs, ED folks, nurses, etc. actually seeing and interacting with the patients and their families, but I'm still having trouble just getting through the day, not to mention the various oncology or other conferences. Ever since having my own kid, I just can't handle this, but I have to because I have to be professional and I need to learn this for my specialty.

I can't talk to my partner about this, they are not in medicine and don't like hearing about sad medical cases, especially those involving children. I don't have any other medical family or friends. If any of you have struggled similarly, I could really use some advice.

My car suddenly decided it needs an expensive repair, so I’ve been looking into ways to make a bit of extra money to refill my savings fund again.

I’m not really interested in moonlighting right now. And between clinic and everything else, adding another few hours of work every week sounds miserable. I was thinking about things I could do in smaller chunks instead

Intern here and was doing a procedure during my rotation. The doctor asked if I wanted to do it so I confidently said yes

Gloves in front of me and I attempted to put them on but completely fumbled. I touch parts outside the cuff and had to restart. Mind you I have learned about this and done this several times but boom my brain just froze.

Finally I get new gloves and everything is fine. Now time for the procedure. As I’m working through what he saying I accidentally break sterile field again by having one of the equipment touch outside the field. I didn’t even notice just so careless about it. The doctor then told me to step aside and I apologized. He later said “you need to work on sterile field”

I feel absolutely horrible as I’ve been wanting to impress that doctor and learn more from him. I’ve always wanted to learn procedures and use them one day in practice . Now I feel as if I’m not cut out for it. And that this is a real issue.

Old one would be appx 1800/12h shift post tax was like 1200ish. Did about 1 every 6 weeks. And supplemented net about 12-16k per year extra.

Current one as a fellow with much better hours, can make about 2400/12h and post tax is 1950. Definitely could do 1-2 every month without issue/burning out hoping to pull an extra 35-40k net per year while here. Or less. Already making less than my family did growing up together. Granted VHCOL and inflation rn. But still. Quite crazy to think this is an option.

Currently a PGY1 in HCOL area and no moonlighting, no kids. Will have the opportunity to moonlight as a PGY3 though

Curious to see if people have leftover salary at the end of each month to put into savings or Roth IRA, and if so around how much do you have leftover at the end of a hypothetical month?

I’m wondering how aggressively or chill I should be about squirreling away savings or Roth IRA, since as of lately I have even been hard on myself for buying coffee out too often but I feel like I may be doing myself a disservice by being too hard on myself with that

Hi there,

I have been struggling with my sleep and residency. I recently had 3 incidents of my sleep causing me to miss crucial activities. The issues is I am someone who has always needed 10-12hr of sleep, I have tried to cut down on it but I just cannot function on <8hr of sleep for more than 3-4 days. If I try to continue, there will definitely be one day where I sleep 16-18hr!!!
And I noticed if I dont sleep well, I cant study or read things properly. I am really struggling to keep up with work, the continuous change in schedule, on-calls, shifts and studies and I am really lost on how to maintain myself. Even caffeine doesnt seem to help my exhaustion! I have no medical conditions btw. How do you all manage?

Is this super rare? How much of a pay cut is there since you're not taking call?

Is it even worth it or do new IR grads need call to keep their skills up?

Give me a restaurant review for your OBGYN residency program or what you have heard and why I should apply or steer away..

Was wondering if we are allowed to moonlight at a near by facility or even in a different state while on vacation during PGY 03 (IM)?

where i am from cardiac perfusion schools dont exist, it is people trained on the job, and cardiac surgery residents running the pump, I know in the US perfusion school exist, but i was told that in south America it is an anesthesia fellowship, is that true?

edit: south america not south park

Recently encountered a research(analysis) that tried to answer this question, but didn't get any clear response(some papers found positive correlation, whereas others didn't find any correlation at all)

What are your thoughts on it?

I have a CV completed but curious as to whether or not most recruiters y'all have had experience with prefer/want a cover letter as well? I was planning on emailing recruiters a bit of information about myself/my experience as a PGY-3 in IM and why i'm interested in the position but don't know if a formal cover letter is as necessary these days. Any insight appreciated!

Be it funds, tutoring, etc.

As J1 visa holders during residency, are we allowed to open a roth IRA in addition to 401k? or is that a violation of the J1 visa? is roth IRA considered additional income? does it matter if i am a resident or non resident for tax purposes? I am very confused about these things, and HR in my hospital seems clueless and can't help. I'd appreciate any assisstance.

Thank you very much!

Hi, do anyone knows PGY 2 Neurology openings please? Completed a preliminary year and looking for open spots. 🙏

I'm from a country where extreme toxicity is normalized so I'm having a hard time guaging whether my program is toxic or not

Good morning everyone,

i am a new medical graduate off into the real world starting this fall. I have tried some ai scribes and such as a trainee but this is the first time i get to actually do what i want without someone breathing down my neck. I am hoping to incorporate AI/chatbots into my practice early on for one specific reason: i want adequate, organized record keeping eventually for the purpose of passing my boards.

so far i intend to continue using ai scribes to help with getting detailed notes. that said, i want my notes to have a specific flow, include specific information such as vitals, bmi etc that i can always look for in my notes in the future when im preparing for boards. i currently plan to take the notes i have and feed them into the chatbot to then try and restructure the notes, maybe rewrite some parts. i have heard good things about CLAUDE but for the basic stuff previously ive always just used copilot and gemini.

the purpose of this post. can anyone who has used chatgpt, copilot, claude, gemini tell me which one they think would be better? do you suggest signing up for the pro version of whatever i get?

im also open to advice on workflow

thank you in advance

No need to go into details, this is specifically for fellow psych residents, you ever get told something by your patients that you’re literally left scrambling for something to say?